Fundamentals of Nursing

KOZIER AND ERB'S Fundamentals of Nursing

VOLUME ONE Cover art Robert Stuurman is a Noongar from Western Australia who does Aboriginal art as a result of meeting his birth mother in 1994. He is from the Stolen Generations. The cover of this book is adapted from one of his paintings called The Learning Experience. It was done through a selection of natural pigments crushed from ochre rock. The painting shows two U-shaped icons facing each other within a concentric circle. The one on the left represents the student and the one on the right is the teacher. Both come from a background of life experience, learning and enquiry. When dialogue occurs the knowledge systems begin to flow like a river. (Dry river beds become raging rivers-our land can also tell a story.) Concentric circles represent age-old and timeless truths (learning truths), where people can grow strong through knowledge and understanding. Arrow-like markings represent footsteps and a willingness to come together in a mutual understanding of teaching and learning.

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Authorised adaptation from the United States edition entitled Kozier & Erb's Fundamentals of Nursing, 8th edition, ISBN 0131714686 by Berman, Audrey; Snyder, Shirlee; Kozier, Barbara; Erb, Glenora, published by Pearson Education, Inc, publishing as Prentice Hall , Copyright© 2008.

The Copyright Act 1968 of Australia allows a maximum of one chapter or 10% of this book, whichever is the greater, to be copied by any educational institution for its educational purposes provided that that educational institution (or the body that administers it) has given a remuneration notice to Copyright Agency Limited (CAL) under the Act. For details of the CAL licence for educational institutions contact: Copyright Agency Limited, telephone: (02) 9394 7600, email: [email protected]

All rights reserved. Except under the conditions described in the Copyright Act 1968 of Australia and subsequent amendments, no part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means, electronic, mechan ical, photocopying, recording or otherwise, without the prior permission of the copyright owner.

Aboriginal and Torres Strait Islander readers should be aware that this publication may contain images or names of people who have died.

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National Library of Australia Cataloguing-in-Publication Data Title: Kozier and Erb's fundamentals of nursing: volume 1/ Audrey Berman .. . [et al.]. Edition: 2nd ed. ISBN: 9781442541672 (vol. 1: pbk) Notes: Includes index. Subjects: Nursing- Australia-Textbooks. Other Authors/ Contributors: Berman, Audrey. Kozier, Barbara. Erb, Glenora Lea. Dewey Number: 610.730994

_Every effort has been made to u·ace and acknowledge copyright. However, should any infringement have occurred, the publishers tender their apologies and invite copyright owners to contact them.

PEARSON About the Authors xiii VOLUME2 About the Australian Authors xv Unit 6 Preface xviii Our Core Philosophies xix Integral Aspects of Nursing 503 Features xxi CHAPTER 26 Caring 504 Contributors xxvi CHAPTER 27 Communicating 521 ta\ VOLUME1 CHAPTER 28 Teaching and Learning 558 CHAPTER 29 Leading, Managing and Delegating 587 WJ Unitl The Nature of Nursing 1 UNIT7 CHAPTER 1 Historical and Contemporary Nursing Practice 2 Assessing Health 601 CHAPTER 2 Nurse Education, Research and Evidence-Based CHAPTER 30 Vital Sig ns 602 Practice 24 CHAPTER 31 Health Assessment 649 CHAPTER 3 Nursing Theories and Conceptual Frameworks 40 UNITS CHAPTER 4 Legal Aspects of Nursing 58 CHAPTER 5 Values, Ethics and Advocacy 89 Integral Components of Client Care 739 CHAPTER 32 Infection Prevention and Control 740 Unit 2 CHAPTER 33 Safety 793 Contemporary Health Care 109 CHAPTER 34 Hygiene 834 CHAPTER 6 Hea lth Care Delivery Systems 110 CHAPTER 35 Diagnostic Testing 893 CHAPTER 7 Community Health Nursing 127 CHAPTER 36 Medications 929 CHAPTER 8 Home Care 142 CHAPTER 37 Skin Integrity and Wound Care 1007 CHAPTER 9 Rural and Remote Nursing 157 CHAPTER 38 Perioperative Nursing 1044 CHAPTER 10 Health Information and Communication Technology 172 ta\ VOLUME3 Unit 3 W uNIT9 The Nursing Process 195 Promoting Psychosocial Health 1087 CHAPTER 11 Critical Thinking and the Nursing Process 196 CHAPTER 39 Sensory Perception 1088 CHAPTER 12 Assessi ng 21 1 CHAPTER 40 Self-Concept 1111 CHAPTER 13 Diagnosing 233 CHAPTER 41 Sexuality 1128 CHAPTER 14 Planning 250 CHAPTER 42 Spirituality 1153 CHAPTER 15 Implementing and Evaluating 274 CHAPTER 43 Stress and Coping 1173 CHAPTER 16 Documenting and Reporting 288 CHAPTER 44 Loss, Grieving and Death 1195 CHAPTER 45 Mental Health Nursing 1220 Unit4 Health Beliefs and Practices 311 UNIT 10 CHAPTER 17 Health Promotion 312 Promoting Physiological Health 1247 CHAPTER 18 Health, Wellness and Illness 339 CHAPTER 46 Activity and Exercise 1248 CHAPTER 19 Cu lt ures and Nursing 357 CHAPTER 47 Sleep 1307 CHAPTER 20 Complementary and Alternative Therapies 377 CHAPTER 48 Pa in Management 1332 Unit 5 CHAPTER 49 Nutrition 1379 CHAPTER 50 U_rinary_F liminritinn 1432 Lifespan Development 395 CHAPTER 51 Faeca l Elimination 1477 CHAPTER 21 Concepts of Growth and Development 396 CHAPTER 52 Oxygenation 1516 CHAPTER 22 Promoting Health from Conception through to CHAPTER 53 Circulation 1562 Adolescence 416 CHAPTER 54 Fluid, Electrolyte and Acid- Base Balance 1587 CHAPTER 23 Promoting Hea lth in Young and Middle-Aged Adults 445 Appendix: Evidence-Based Practice and ANMC Mapping A-1 CHAPTER 24 Promoting Health in Older Adults 462 Glossary G-1 CHAPTER 25 Promoting Family Health 488 Index 1-1 About the Authors xiii Nursing Ethics 96 About the Australian Authors xv Specific Ethical Issues 100 Preface xviii Advocacy 102 Our Core Philosophies xix Features xxi UNIT 2 Contributors xxvi CONTEMPORARY HEALTH CARE 109 VOLUME 1 CHAPTER6 HEALTH CARE DELIVERY SYSTEMS 110 «i) uNIT1 Types of Health Care Services 111 THE NATURE OF NURSING 1 Types of Health Care Agencies and Services 112 Providers of Health Care 115 CHAPTER 1 Factors Affecting Health Care Delivery 11 8 HISTORICAL AND CONTEMPORARY The Au stralian Health System 11 8 NURSING PRACTICE 2 Frameworks for Care 121 Historical Perspectives 3 Financing Hea lth Care 122 Contemporary Nursing Practice 9 Roles and Functions of the Nurse 13 CHAPTER 7 Criteria of a Profession 15 COMMUNITY HEALTH NURSING 127 Socialisation to Nursing 16 Health Care Reform 128 Factors Influencing Contemporary Nursing Practice 17 Community-Based Health Care 130 Nursing Organisations 19 Community Health 132 Community Hea lth and Primary Health Ca re 134 CHAPTER 2 Community-Based Nursing 137 NURSE EDUCATION, RESEARCH AND EVIDENCE-BASED PRACTICE 24 CHAPTERS Nurse Ed ucation 26 HOME CARE 142 Types of Educational Programs 27 Home Health Nursing 144 Nursing Research and Evidence-Based Practice 30 The Home Hea lt h Care System in Australia 145 Critiquing Research Reports 36 Roles of the Home Health Nurse 147 Perspectives of Home Care Clients 148 CHAPTER3 Selected Dimensions of Home Health Nursing 148 NURSING THEORIES AND CONCEPTUAL Nurse Safety 149 FRAMEWORKS 40 The Practice of Nursing in t he Home 151 Introduction to Theories 41 The Future of Home Health Care 153 The Metaparadigm for Nursing 42 CHAPTER 9 Purposes of Nursing Theory 43 Overview of Selected Nursing Theories 44 RURAL AND REMOTE NURSING 157 Nursing Theorists in Australia 53 Overview 158 Critique of Nursing Theory 54 What is Ru ral and Remote Nursing? 159 The Rural and Remote Nursing Workforce 160 CHAPTER4 Primary Health Care and Rural and Remote Nursing 161 LEGAL ASPECTS OF NURSING 58 The Health of Rural Au stralia 162 Legal Aspects of Nursing 59 Access to Health Services in Rural and Remote Areas 163 Regulation of Nursing Practice 67 Indigenous Health and Indigenous Communities in Contractual Arrangements in Nu rsing 70 Rural and Remote Au stralia 165 Selected Legal Aspects of Nursing Practice 73 CHAPTER 10 Areas of Potential Liability in Nursing 78 Legal Protections in Nursing Pra ctice 83 HEALTH INFORMATION AND Reporting Crimes, Torts and Unsafe Practices 85 COMMUNICATION TECHNOLOGY 172 Legal Responsibilities of Students 85 Health Informatics 173 General Principles of Information Technology 176 CHAPTER 5 Comput ers in Nursing and Midwifery Practice 182 VALU ES, ETHICS AND ADVOCACY 89 Computers in Nursing and Midwifery Education 188 Values 90 Computers in Administration 189 Morality and Ethics 93 Computers in Nursing and Midwifery Research 190 UNIT3 UNIT4 THE NURSING PROCESS 195 HEALTH BELIEFS AND PRACTICES 311 CHAPTER 11 CHAPTER 17 CRITICAL THINKING AND THE HEALTH PROMOTION 312 NURSING PROCESS 196 Individual Health 313 Critical Thinking Uses 197 Applying Theoretical Frameworks 314 Skills in Critical Thinking 198 Defining Health Promotion 317 Attitudes for Critical Thinking 199 Sites for Health Promotion Activities 318 Standards of Critical Thinking 201 Health Promotion Model 319 Applying Critical Thinking to Nursing Practice 202 Stages of Health Behaviour Change 321 Developing Critical Thinking 203 The Nurse's Role in Health Promotion 323 NURSING MANAGEMENT 324 CHAPTER 12 CHAPTER 18 ASSESSING 211 HEALTH, WELLNESS AND ILLNESS 339 Overview of the Nursing Process 212 Concepts of Health, Wellness and Wellbeing 340 Assessing 216 Models of Health and Wel lness 342 Collecting Data 216 Variables Influencing Health Status, Beliefs and Practices 345 Organising Data 225 Health Belief Models 347 Validating Data 229 Health Care Concordance 349 Documenting Data 230 Illness and Disease 351

CHAPTER 13 CHAPTER 19 DIAGNOSING 233 CULTURES AND NURSING 357 NANDA-I Australian Context 234 National Organisations and Trends 358 NANDA-I Nursing Diagnoses 234 Cultural Nursing Care 359 The Diagnostic Process 238 Concepts Related to Cultural Nursing Care 360 Ongoing Development of Nursing Diagnoses 245 Heritage Consistency 362 Selected Parameters for Cultural Nursing Care 362 CHAPTER 14 Providing Cultural Nursing Care 368 PLANNING 250 NURSING MANAGEMENT 369 The Classification System in Australia 251 CHAPTER20 Types of Planning 251 Developing Nursing Care Plans 252 COMPLEMENTARY AND ALTERNATIVE The Planning Process 257 THERAPIES 377 The Nursing Interventions Classification 266 Basic Concepts 378 Ethnocentrism and Medical Intransigence 379 CHAPTER 15 UNIT 5 IMPLEMENTING AND EVALUATING 274 Implementing 275 LIFESPAN DEVELOPMENT 395 Evaluatinq 278 CHAPTER 21 CONCEPTS OF GROWTH AND DEVELOPMENT 396 CHAPTER 16 Factors Influencing Growth and Development 397 DOCUMENTING AND REPORTING 288 Stages of Growth and Development 398 Ethical and Legal Considerations 289 Growth and Development Theories 398 Purposes of Patient Records 289 Applying Growth and Development Concepts to Nursing Documentation Systems 290 Practice 410 Documenting Nursing Activities 299 CHAPTER22 Documentation in Residential Aged Care Facilities 300 Home Care Documentation 301 PROMOTING HEALTH FROM CONCEPTION General Guidelines for Recording 302 THROUGH TO ADOLESCENCE 416 Reporting 304 Conception and Prenatal Development 417 viii CONTENTS

Neonates and Infants (Birth to 1 Year) 418 CHAPTER28 Toddlers (1 to 3 Years) 424 TEACHING AND LEARNING 558 Preschoolers (4 and 5 Years) 427 Teaching 559 School-Age Children (6 t o 12 Years) 432 Learning 562 Adolescents (12 to 18 Years) 434 Learning Theories 563 The Internet and Health Information 567 CHAPTER 23 Nurse as Educator 567 PROMOTING HEALTH IN YOUNG AND NURSING MANAGEMENT 568 MIDDLE-AGED ADULTS 445 Young Adults (20 to 40 Years) 446 CHAPTER 29 Middle-Aged Adults (40 to 65 Years) 453 LEADING, MANAGING AND DELEGATING 587 The Nurse as Leader and Manager 588 CHAPTER 24 PROMOTING HEALTH IN OLDER ADULTS 462 Leadership 589 Management 591 Characteristics of Older Adults in Australia 463 Clinical Governance 595 Attitudes towards Ageing 465 Change 596 Gerontological Nursing 466 Care Settings for Older People 467 Physiological Ageing 469 UNIT7 Psychosocial Ageing 475 Cognitive Abilities and Ageing 477 ASSESSING HEALTH 601 Moral Reasoning 478 CHAPTER 30 Spirituality and Ageing 478 VlfAl:'"SIGNS 602 Health Problems 478 Documentation of Vital Signs 604 Health Assessment and Promotion 481 Respiration 604 SKILL 30.1 Assessing Respiration CHAPTER25 608 Oxygen Saturat ion 610 PROMOTING FAMILY HEALTH 488 SKILL 30.2 Measuring Oxygen Saturation 612 Family Health 489 Blood Pressu re 614 Applying Theoretical Frameworks to Families 491 SKILL 30.3 Assessing Blood Pressure 619 NURSING MANAGEMENT 493 Pul se or Heart Rate 623 SKILL 30.4 Assessing a Peripheral Pu lse 626 VOLUME2 SKILL 30.5 Assessing an Apical Pulse 629 UNIT6 SKILL 30.6 Assessing an Apical- Radial Pulse 631 Body Temperature 632 INTEGRAL ASPECTS OF NURSING 503 SKILL 30.7 Assessing B~dy Temperature 638 CHAPTER26 CARING 504 CHAPTER 31 Professionalisation of Caring 505 HEALTH ASSESSMENT 649 Nursing Theories on Caring 505 Physical Health Assessment 650 Types of Knowledge in Nursi ng 509 General Assessment 657 Caring Encounters 511 SKILL 31.1 Assessing Appearance and Mental Status 658 Maintaining Caring Practice 513 The Integument 662 SKILL 31.2 Assessing the Skin 665 CHAPTER 27 SKILL 31.3 Assessing the Hair 669 COMMUNICATING 521 SKILL 31.4 Assessing the Nails 671 Communicating 522 The Head 672 Therapeutic Re lationships 536 SKILL 31.5 Assessing the Skull and Fa ce 673 Group and Team Communication 541 SKILL 31.6 Assessing the Eye Structures and Communication and the Nursing Process 544. Visual Acuity 676 NURSING MANAGEMENT 544 SKILL 31.7 Assessing t he Ears and Hearing 680 Communication between Hea lth Professionals 548 SKILL 31.8 Assessing the Nose and Sinuses 684 CONTENTS ix

SKILL 31.9 Assessing the Mouth and Oropharynx 685 SKILL 32.5 Donning a Sterile Gown and Gloves The Neck 688 (Closed Method) 784 SKILL 31.10 Assessing the Neck 690 Infection Control for Hea lth Care Workers 786 The Thorax and Lungs 691 Role of the Infection Control Nurse 787 SKILL 31.11 Assessing the Thorax and Lungs 695 CHAPTER 33 The Cardiovascular and P~ripheral Va scular Systems 697 SKILL 31.12 Assessing the Heart and Central Vessels 700 SAFETY 793 Factors Affecting Safety 795 SKILL 31.13 Assessing the Peripheral Vascular System 703 NURSING MANAGEMENT 800 The Breasts and Axillae 705 SKILL 33.1 Using a Bed or Chai r Exit Safety SKILL 31.14 Assessing the Breasts and Axillae 705 Monitoring Device 812 The Abdomen 709 SKILL 33.2 Implementing Seizure Precautions 814 SKILL 31.15 Assessing the Abdomen 710 SKILL 33.3 Applying Restraints 825 The Musculoskeletal System 714 SKILL 31.16 Assessing the Musculoskeletal System 715 CHAPTER 34 The Neurological System 72 1 HYGIENE 834 SKILL 31.17 Assessing the Neurological System 724 Hygienic Care 835 The Female Genitals and Inguinal Area 729 Skin 835 SKILL 31.18 Assessing the Female Genitals and NURSING MANAGEMENT 836 Inguinal Area 729 SKILL 34.1 Bathing an Adult or Paediatric Cl ient 840 The Male Genitals and Inguinal Area 731 SKILL 34.2 Providing Perineal- Genital Care 849 SKILL 31.19 Assessing the Male Genitals and Inguinal Area 732 Feet 85 1 The Rectum and Anus 734 NURSING MANAGEMENT 852 SKILL 31.20 Assessing the Rectum and Anus 734 SKILL 34.3 Providing Foot Care 855 Nails 856 UNITS NURSING MANAGEMENT 856 INTEGRAL COMPONENTS OF Mouth 857 NURSING MANAGEMENT 858 CLIENT CARE 739 SKILL 34.4 Brushing and Flossing the Teeth 862 CHAPTER 32 SKILL 34.5 Providing Special Oral Care for the INFECTION PREVENTION AND CONTROL 740 Unconscious Client 865 Micro-organisms 741 Hair 867 Pathogens: Colonisation and Infection 742 NURSING MANAGEMENT 867 Types of Infection 744 SKILL 34.6 Providing Hair Care for Clients 870 SKILL 34.7 Shampooing the Hair of a Client Confined Chain of Infection 744 to Bed 871 Body Defences Against Infection 747 Eyes 874 Factors Increasing Susceptibility to Infection 749 NURSING MANAGEMENT 874 Measures to Reduce or Eliminate Infectious Agents 753 Ears 877 Standard Precautions 754 SKILL 34.8 Removing, Cleaning and Inserting a Asepsis and Aseptic Technique 760 Hearing Aid 878 Health Care Associated Infections (HAI) 764 Nose 880 NURSING MANAGEMENT 768 Supporting a Hygienic Environment 880 SKILL 32.1 Hand Washing Technique 773 Making Beds 882 SKILL 32.2 Donning and Removing Personal Protective SKILL 34.9 Changing an Unoccupied Bed 883 Equipment (G loves, Gown, Mask, Eyewear) 776 SKILL 34.10 Changing an Occupied Bed 886 Aseptic Fields 778 SKILL 32.3 Establishing and Maintaining a CHAPTER35 Critical Aseptic Field 778 DIAGNOSTIC TESTING 893 SKILL 32.4 Donning and Removing Sterile Diagnostic Testing Phases 894 Gloves (Open Method) 783 Blood Tests 895 Specimen Collection 903 CHAPTER38 SKILL 35.1 Obtaining a Capillary Blood Specimen PERIOPERATIVE NURSING 1044 to Measure Blood Glucose 904 The Perioperative Workforce 1045 SKILL 35.2 Collecting a Urine Sample for Culture and Standards and Guidelines 1046 Sensitivity by Midstream Specimen of Urine (MSU) 909 Types of Surgery 1046 Visualisation Procedures 915 Preoperative Phase 1048 Aspiration/Biopsy 918 NURSING MANAGEMENT 1049 SKILL 38.1 Teaching Moving, Leg Exercises, Deep CHAPTER 36 Breathing and Coughing 1052 MEDICATIONS 929 SKILL 38.2 Applying Antiemboli Stockings 1058 Drug Standards 931 lntraoperative Phase 1060 Legal Aspects of Drug Administration 932 NURSING MANAGEMENT 1061 Effects of Drugs 933 Postoperative Pha se 1062 Drug Misuse 935 NURSING MANAGEMENT 1064 Actions of Drugs on the Body 935 SKILL 38.3 Managing Gastrointestinal Suction 1072 Factors Affecting Medication Action 937 SKILL 38.4 Cleaning a Sutured Wound and Applying a Routes of Administration 939 Sterile Dressing 1075 Medication Orders 940 Systems of Measurement 946 VOLUME3 Administering Medications Safely 950 Oral Medications 956 .UNIT9 SKILL 36.1 Administ ering Oral Medications 956 PROMOTING PSYCHOSOCIAL Nasogastric and Gastrostomy Medications 960 HEALTH 1087 Parenteral Medications 960 SKILL 36.2 Preparing Medications from Ampoules 966 CHAPTER 39 SKILL 36.3 Preparing Medications from Vials 967 SENSORY PERCEPTION 1088 SKILL 36.4 Mixing Medications Using One Syringe 969 Components of the Sensory Experience 1089 SKILL 36.5 Administering an lntradermal Injection Sensory Alt erations 1089 for Skin Tests 970 Factors Affecting Sensory Function 1091 SKILL 36.6 Administering a Subcutaneous Injection 974 NURSING MANAGEMENT 1092 SKILL 36.7 Administering an Intramuscular Injection 980 CHAPTER40 SKILL 36.8 Adding Medications to Intravenous Fluid Containers 982 SELF-CONCEPT 11 11 SKILL 36.9 Administering Intravenous Medications Self-Concept 111 2 Using IV Push 987 Formation of Self-Concept 111 2 SKILL 36.10 Administering Ophthalmic Instillations 991 Components of Self-Concept , 1114 SKILL 36.1 1 Administering Otic Instillations 994 Factors that Affect Self-Concept 111 5 SKILL 36.12 Administering Vaginal Instillations 997 NURSING MANAGEMENT 1117 Respiratory Inhalation 1000 CHAPTER41 Irrigations 1002 SEXUALITY 11 28 Development of Sexuality 1129 CHAPTER37 Sexual Health 1132 SKIN INTEGRITY AND WOUND CARE 1007 Varieties of Sexuality 1134 Skin Integrity 1008 Factors Influencing Sexuality 1135 Types of Wounds 1008 Sexual Response Cycle 1136 Pressure U leers 1008 Altered Sexual Function 11 38 Wound Healing 1013 NURSING MANAGEMENT 1141 NURSING MANAGEMENT 1016 SKILL 37.1 Obtaining a Wound Drainage Specimen CHAPTER42 for Culture 101 9 SPIRITUALITY 11 53 SKILL 37.2 Irrigating a Wound 1030 Spirituality Described 11 54 Related Concepts 1156 CHAPTER47 Spiritual Development 1157 $LEEP- 1307 Spiritual Practices Affecting Nursing Care 1157 Physiology of Sleep 1308 Spiritual Health and the Nursing Process 1161 Functions of Sleep 1310 NURSING MANAGEMENT 1161 Normal Sleep Patterns and Requirements 1310 Factors Affecting Sleep 1313 CHAPTER 43 Common Sleep Disorders 1316 STRESS AND COPING 1173 NURSING MANAGEMENT 131 8 Concept of Stress 1174 Models of Stress 1174 CHAPTER48 Indicators of Stress 1177 PAIN MANAGEMENT 1332 Coping 1181 The Nature of Pain 1333 NURSING MANAGEMENT 1182 Physiology of Pain 1337 NURSING MANAGEMENT 1343 CHAPTER 44 SKILL 48.1 Providing a Back Massage 1366 LOSS, GRIEVING AND DEATH 1195 Loss and Grief 1196 CHAPTER49 NURSING MANAGEMENT 1202 l\JTJTR ITIO N 1379 Dying and Death 1205 Essential Nutrients 1380 NURSING MANAGEMENT 1208 Energy Balance 1384 Body Weight and Body Mass Standards 1385 CHAPTER 45 Factors Affecting Nutrition 1386 MENTAL HEALTH NURSING 1220 Nutritional Variations Throughout the Life Cycle 1391 Holistic Mental Health Care 1221 Standards for a Healthy Diet 1395 Mental Health and Mental Illness 1221 Altered Nutrition 1401 The Role of the Mental Health Nurse 1226 NURSING MANAGEMENT 1402 Mental Health Nursing in Practice 1226 SKILL 49.1 Inserting a Nasogastric Tube 1414 Mental Health Legislation 1227 SKILL 49.2 Removing a Nasogastric Tube 1417 Mental State Assessment (MSA) 1231 SKILL 49.3 Administering a Tube Feeding 1420 Types of Mental Illness 1232 SKILL 49.4 Administering a Gastrostomy or Suicide 1237 Jejunostomy Feeding 1423 Treatments in Mental Health 1238 Mental Health Care Models 1240 CHAPTER SO Recovery vs Rehabilitation 1243 URINARY ELIMINATION 1432 Physiology of Urinary Elimination 1433 UNIT 10_ Factors Affecting Voiding 1435 P-RnMOTING PHYSIOLOGICAL HEALTH 1247 Altered Urine Production 1439 Altered Urinary Elimination 1440 CHAPTER46 NURSING MANAGEMENT 1443 ~eT l\TITY AND EXERCISE 1248 SKILL 50.1 Urinalysis 1445 ormal Movement 1250 SKILL 50.2 Applying an External Urinary Sheath 1455 Exercise 1256 SKILL 50.3 Performing Urinary Catheterisation 1458 Factors Affecting Body Alignment and Activity 1260 SKILL 50.4 Performing Bladder Irrigation 1466 Effects of Immobility 1263 NURSING MANAGEMENT 1267 CHAPTER51 SKILL 46.1 Client-Assisted Bed Slide: One Nurse 1282 FA ECAL ELIMINATION 1477 SKILL 46.2 Bed Slide: Two Nurses 1283 The Digestive System 1478 SKILL 46.3 Lateral Shift and Roll: Two Nurses 1283 Large Intestine 1479 SKILL 46.4 Logrolling a Client: Two to Four Nurses 1284 Rectum and Anal Canal 1479 SKILL 46.5 Bed to Chair Slide: One or Two Nurses 1284 Physiology of Defecation 1479 SKILL 46.6 Bed to Chair (4-Point Frame): Two Nurses 1285 Factors that Affect Defecation 1482 SKILL 46.7 Assisting the Client to Sit on the Side of the Bed 1285 Faecal Elimination Problems 1484 SKILL 46.8 Assisting the Client to Ambulate 1290 NURSING MANAGEMENT 1489 xii CONTENTS

SKILL 51.1 Administering an En ema 1498 CHAPTER 54 Bowel Diversion Ostomies 1501 FLUID, ELECTROLYTE AND SKILL 51.2 Changing a Bowel Diversion Stoma Appliance 1505 ACID-BASE BALANCE 1587 CHAPTER52 Body Fluids and Electrolytes 1588 OXYGENATION 1516 Acid-Base Balance 1596 Structure and Function of the Respiratory System 15 17 Factors Affecting Body Fluid, Electrolytes and Respiratory Regu lation 1521 Acid-Base Balance 1597 Factors Affecting Respiratory Function 1521 Disturbances in Fluid Volume, Electrolyte Alterations in Respiratory Function 1522 and Acid-Base Balances 1599 NURSING MANAGEMENT 1524 NURSING MANAGEMENT 1607 SKILL 52.1 Administering Oxygen by Cannula, Face Mask, Non-Rebreather Mask or Face Tent 1537 SKILL 54.1 Starting an Intravenous Infusion 1626 SKILL 52.2 Oropharyngeal and Nasopharyngeal Suctioning 1